个案管理模式的康复护理决策方案在冠心病伴心力衰竭患者中的应用效果

doi:10.3760/cma.j.cn441417-20250228-15031

摘要/Abstract

摘要：

目的　探讨个案管理模式的康复护理决策方案在冠心病伴心力衰竭患者中的应用效果。方法　选取2022年7月至2024年7月郑州市第七人民医院收治的96例冠心病伴心力衰竭患者作为研究对象。采用随机数字表法，将患者分为观察组和对照组，各48例。观察组男31例，女17例；年龄44～77（62.48±9.13）岁；纽约心脏病协会（NYHA）分级：Ⅱ级25例，Ⅲ级14例，Ⅳ级9例。对照组男28例，女20例；年龄42～80（63.08±9.63）岁；NYHA分级：Ⅱ级23例，Ⅲ级18例，Ⅳ级7例。对照组采用常规护理干预，观察组在对照组基础上采用个案管理模式的康复护理决策方案干预。两组均连续干预3个月。比较两组干预前后心功能［左心室收缩末期内径（LVESD）、左心室射血分数（LVEF）］、不良心理状态［焦虑自评量表（SAS）、抑郁自评量表（SDS）］、生活质量［36项简明健康状况调查量表（SF-36）］。采用独立样本t检验、配对t检验和χ²检验进行统计学分析。结果　干预后，观察组LVESD低于对照组［（35.83±2.88）mm比（39.23±3.39）mm］，LVEF高于对照组［（49.70±5.44）%比（44.12±5.08）%］（均P<0.05）；观察组SAS、SDS评分均低于对照组［（40.92±5.31）分比（46.26±5.30）分、（42.11±5.23）分比（47.05±5.05）分］（均P<0.05）；观察组SF-36各维度（生理功能、社会功能、情感职能、总体健康）评分均高于对照组（均P<0.05）。结论　冠心病伴心力衰竭患者采用个案管理模式的康复护理决策方案干预可有效促进心功能恢复，改善不良心理状态，提高生活质量。

关键词:

冠心病, 心力衰竭, 个案管理, 康复护理, 护理决策

Abstract:

Objective　To explore the application effect of rehabilitation nursing decision scheme based on case management model in patients with coronary heart disease and heart failure. Methods　A total of 96 patients with coronary heart disease and heart failure who were admitted to the 7th People's Hospital of Zhengzhou from July 2022 to July 2024 were selected as the research subjects. Using the random number table method, the patients were divided into the observation group and the control group, with 48 cases in each group. There were 31 males and 17 females in the observation group, aged 44-77 (62.48±9.13) years, New York Heart Association (NYHA) classification: 25 cases at grade Ⅱ, 14 cases at grade Ⅲ, and 9 cases at grade Ⅳ. There were 28 males and 20 females in the control group, aged 42-80 (63.08±9.63) years, NYHA classification: 23 cases at grade Ⅱ, 18 cases at grade Ⅲ, and 7 cases at grade Ⅳ. The control group received conventional nursing intervention, while the observation group was given the rehabilitation nursing decision scheme based on case management model in addition to the intervention of the control group. Both groups were subjected to continuous intervention for 3 months. The cardiac function [left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF)], adverse psychological states [Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS)], and quality of life [36-Item Short-Form Health Survey (SF-36)] were compared before and after the intervention between the two groups. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　After the intervention, the LVESD of the observation group was lower than that of the control group [(35.83±2.88) mm vs. (39.23±3.39) mm], and the LVEF was higher than that of the control group [(49.70±5.44)% vs. (44.12±5.08)%] (both P<0.05); the SAS and SDS scores of the observation group were both lower than those of the control group [(40.92±5.31) points vs. (46.26±5.30) points, (42.11±5.23) points vs. (47.05±5.05) points] (both P<0.05); the scores of each dimension of SF-36 (physiological function, social function, emotional function, overall health) of the observation group were all higher than those of the control group (all P<0.05). Conclusion　The application of a case management model for rehabilitation nursing decision scheme in patients with coronary heart disease and heart failure can effectively promote the recovery of cardiac function, improve negative psychological states, and enhance the quality of life.

Key words:

Coronary heart disease, Heart failure, Case management, Rehabilitation nursing, Nursing decision

孟芳芳余丽娅康樱樱吴瑞欣朱青春王宁波.

个案管理模式的康复护理决策方案在冠心病伴心力衰竭患者中的应用效果 [J]. 国际医药卫生导报, 2025, 31(15): 2621-2625.

Meng Fangfang, Yu Liya, Kang Yingying, Wu Ruixin, Zhu Qingchun, Wang Ningbo.

The application effect of the rehabilitation nursing decision scheme based on case management model in patients with coronary heart disease and heart failure [J]. International Medicine and Health Guidance News, 2025, 31(15): 2621-2625.

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